A story about dying that ended up being a story about living

I want to tell you a story about dying that ended up being a story about living.

A few years ago, I was an eager-beaver third-year medical student, and relished the opportunity to finally work on the wards. One of my patients was Mr. Taylor, a middle-aged man with pancreatic cancer—a disease that, of course, carries a bleak prognosis. He was emaciated, but the contours of his muscles suggested an athletic vigor back in his prime. Flowers, balloons, and photos brightened an otherwise sterile room, testaments that he was beloved by an abundance of family and friends. Our team was making rounds, and we had the unenviable task of letting Mr. Taylor know that there was not much more we could do for him. We walked into the room with sullen faces and broke the news.

Then something curious happened.

Mr. Taylor, rather than being depressed or defensive, was surprisingly stoic, and even had the hint of a glimmer in his piercing green eyes. He looked around, smiling, and said: “I’ve had a great life. Thank you all for taking care of me. I know that you’ve done your best.”

Him, thanking me? I was shocked.

Here Mr. Taylor was, on the threshold of death. Yet he was a beacon of optimism, expressing his gratitude, even though we had essentially failed at our job. It certainly put my own problems—the call-schedule, a looming exam—into proper perspective. At the same time, I was amused that, in one glistening moment, a patient had taught me more than weeks of didactics and textbook-reading ever will.

Mr. Taylor’s attitude stands in stark contrast to the small, but noticeable, number of pessimistic physicians I’ve come across. “It’s important to keep a safe emotional distance from the patient,” they tell me. Or worse: “Medicine is a business; nothing more and nothing less.” I don’t know why they think that way. Perhaps they’re hardened by the passing years, so that what was once miraculous has now become mundane.

It’s sad that they’ve resigned themselves to such thoughts. I hope this doesn’t happen to me, or any of my colleagues who are just beginning their careers in medicine. After all, we are privileged to be intimate participants in the gamut of the human experience. We are privy to a family’s deepest and darkest secrets, and administer chest compressions to a patient gasping his last breaths. We determine when an injured athlete can go back to the school track team, and start intravenous benzodiazepines when a drunk has been to the bar one too many times. Heck, I’ve even witnessed a Jewish orthodox wedding in the cardiac care unit.

So how do we stay happy in our careers, and not end up bitter and jaded? It’s more than just chasing professional prestige and a steady income, which we already have in spades. Instead, it’s about retaining the enthusiasm with which we entered medicine, and remembering that being a doctor entails a responsibility to others that goes far beyond diagnosis and treatment.

I’m not naïve. I realize that getting sucked into the humdrum of life in the hospital, day after day, week after week, it is difficult to sustain these ideals. But it would be an utter shame—to our patients and to ourselves—if we didn’t at least try to bridge the gulf between what exists and what we aspire to be. It’s making small talk with patients during the rush of pre-rounding. It’s lingering an extra few minutes to console grieving family members, and striving for flawless technique when dropping in a central line. It’s reminding ourselves that the 57-year-old admit on the third floor is not merely an end-stage pancreatic cancer patient. He has a name: Robert A. Taylor, retired merchant, loving husband, and proud father of three.

Mr. Taylor’s funeral took place on a glorious spring morning. Several hundred people from the community attended. And while tears of sadness flowed, in true Mr. Taylor-style there was a good amount of humor to punctuate the occasion. Certainly it’s true that there’s nothing like someone’s passing to make us pause and take stock in how our own lives are coming along.

I want to be proud of I do every step of the way, from the time I finish residency to that distant moment when I’ll be turning the lights off in my clinic one last time. When I’m old and gray, I want to be able to look my grandchildren in the eyes and say that, yes, taking on the responsibilities of a physician did leave me with an enduring sense of fulfillment, and yes, I did make a difference, and yes, I’ve had a great life.

Ultimately, it comes back to that ineffable sense of optimism. It is the optimism that Mr. Taylor embodied—the same optimism that I hope will stay with me throughout the course of my career. Always, always, unyielding optimism.

A story about dying that ended up being a story about living 3 comments

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Miranda Fielding

What a wonderful post. Please don’t ever lose that optimism. It will stand you in good stead for the rest of your career. Take it from a 59 year old radiation oncologist who has seen more than her share of pancreatic cancer and other sad diseases. Hoping for the best is what gets you through it.

Mark Samuel

A drunk is a drunk is a drunk, how else can you say it.

http://twitter.com/smsport927 Shal-la-la

I enjoyed your post. I agree that too many docs keep too much of an emotional distance from their patients and the work they do thereby making them seem unsympathetic and too “business-like”. I will offer one criticism, though, to your post. Please do not refer to those who have hit the bar one too many times as drunks. It’s an outdated and disrespectul moniker reserved only for those alcoholics who may call this of themselves but it is not a right you have to call anyone else. Compassion should not be reserved for only those with “dignified” diseases such as cancer, but also for those of us who have or have struggled with substance abuse. Be careful the words you use always!